H.—3l.

The Principal Causes of Death itemized.

It is again noteworthy that these diseases of the heart and arteries- accounted for 3,871 deaths— i.e., 32 per cent, of the total deaths during the year. In 1928 they accounted for 28 per cent., m 1929 29 per cent., and in 1930 32 per cent, of the total. This, by reason of its magnitude and increasing tendency, appears to present a field worthy ol special investigation bv the Department and the medical profession. Certain infectious and other diseases such as scarlet fever, diphtheria, and acute rheumatism, and syphilis are known to sometimes affect the heart and blood-vessels, but their potency and influence has definitely waned. Again, some may regard deaths from these diseases as the inevitable results of fair wear-and-tear, but analysis shows that during the three years ending 1930, of an approximate total of 11,000 deaths in New Zealand from these causes 2,500 occurred before the age of sixty had been reached, 1,100 before age fifty, and 500 before age forty. . . These diseases, then, not only shorten life, but stand out as the mam blot on a clearing horizon. Medical attention to individual patients (usually middle-aged or older persons) does by means of detection of arterio-sclerosis, high blood-pressure, or heart and the alteration of habits including dietary, lengthen their lives, but by co-operative effort in a wider field, commencing at an earlier age and an endeavour to ascertain the fundamental causes of these very common diseases of the heart and blood-vessels it seems possible that longevity could be increased. _ Cancer, another important cause of death, is regarded by many as a disease of civilization. _ this be true, then the necessary correction of the human errors which predispose to cancer will probably prove to be neither a short nor a simple task. There are, in fact, very few examples in medical history of any disease having been eradicated by rapid cure, and in respect of these diseases of the heart and blood-vessels it may be said with greater force than is true of cancer that the results of early diagnosis and medical attention to individual cases appear to justify a wider and earlier application of the process. Moreover, the very fact that our knowledge of the causes of arterio-sclerosis and ot many forms of heart-disease is scanty, itself points to the need of special investigation. The number of annual deaths involved is such as to offer a margin of gain worth the effort. Cancer, 1,493. The following table, taken from the " New Zealand Official Year Book," shows the cancer death rate in the Dominion for the last five years : —

Number of Persons who died from Cancer, the Proportion per 10,000 Persons living, and the Percentage of all Deaths, 1927-31.

We know not the cause of cancer. It is increasing in prevalence at a slow, not rapid, rate._ Being a disease of late life, and having in the past often missed detection or registration, its apparent increase is in considerable measure accounted for by our longer span of life and greater skill in diagnosis. The real increase is slight. . . It has always been an important cause of death, but results show that nowadays submission to skilled treatment at an early stage is worth while. Particularly after the age of thirty-five we should seek medical examination for any unusual condition which might be cancer. Violence, 1,165. Violence has now assumed third place as a cause of deaths in New Zealand ; 926 of these deaths were due to accident, 226 to suicide, and 13 to homicide. The number of deaths from suicide increased from 193 in 1930 to 226 last year. In the last five years the number of deaths annually from motor-vehicle accidents has averaged 174

8

Year. Cause. j 1928. 1929. j 1930. 1931. Heart-diseases (all forms) .. .. 2,315 2,533 Apoplexy or cerebral haemorrhage . . 643 634 659 Diseases of the arteries .. .. 394 428 432 4 Totals .. .. •• 3,352 3,595 3,988 3,871

T , ;1 r I „ . , „ iV , Deaths from Deaths from Y p„r Deaths from ; Total Deaths, Cancer per 10 ,000 Cancer per 100 ! Cancer. all Causes. Q f Living Persons. of all Deaths. ■ - . j _ 1927 1,324 11,613 9-63 11-40 1928 •• •• 1,374 11,811 9-87 11-63 1929 " . .. 1,467 12,314 10-43 11-91 1930 . .. 1,452 12,199 10-19 11-90 1931 .. 1,493 12,047 10-33 12-39